Research on the management of organizational, environmental and antibiotic use for controlling antimicrobial resistance and reducing adverse events in the community.

2022 Fiscal Year Final Research Report

• Project/Area Number: 18K10005
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 58010:Medical management and medical sociology-related
• Research Institution: Shimane University
• Principal Investigator: YANO Takahisa 島根大学, 学術研究院医学・看護学系, 准教授 (90532846)
• Project Period (FY): 2018-04-01 – 2023-03-31
• Keywords: 薬剤耐性菌 / 抗菌薬 / 抗菌薬適正使用 / 感染制御 / 母集団薬物動態解析

Outline of Final Research Achievements

To control antimicrobial resistance and reduce adverse events in local medical institutions, this research focused on managing organizational, environmental, and antibiotic factors. A survey of 84 medical facilities in Fukuoka Prefecture and 24 facilities in Shimane Prefecture revealed personnel shortages, a lack of skilled workforce, and issues with organizational structure. The detection rate of ESBL-producing Klebsiella pneumoniae differed significantly between Fukuoka and Shimane Prefectures. Additionally, ESBL-producing Escherichia coli decreased significantly in both prefectures after the start of this study. Antibiotic usage decreased in Fukuoka Prefecture, while in Shimane Prefecture, it led to the promotion of appropriate use of anti-MRSA drugs and other medications. Individualized optimized dosing methods for drugs such as Piperacillin/Tazobactam were developed through population pharmacokinetic analysis.

Free Research Field

医療管理学

Academic Significance and Societal Importance of the Research Achievements

本研究によって、地域における薬剤耐性菌の制御や薬剤有害事象の低減に関わる問題点や課題点が明らかになった。得られた結果を基に、地域の医療機関を含めた取り組みを実施し、組織や管理体制、薬剤耐性菌制御のための活動の強化に至った。本研究により地域の医療機関における抗菌薬の適正使用の推進につながり、ESBL産生大腸菌は顕著に減少したことから、社会的意義が認められた。加えて、母集団薬物動態解析によってピペラシリン／タゾバクタム配合剤等の抗菌薬の個別最適化投与法の構築に至った。抗菌薬使用時の有効性や安全性の向上に寄与することから、学術的にも意義ある研究成果であることが考えられる。